HEDIS Improvement Nurse (RN) — Hybrid & Impact

Comunidade Metodista; Rancho Cucamonga (CA); Hybrid; USD 51,000 - 69,000; Full time

Job summary

IEHP seeks a Temporary HEDIS Improvement Nurse, RN in Rancho Cucamonga, CA. This agency-facilitated assignment lasts up to six months and supports IEHP’s clinical quality improvement initiatives.

Under supervision, the nurse interprets data for QI studies and maintains knowledge of MedHOK and related regulatory requirements from DHCS, DMHC, and CMS, contributing to IEHP’s quality goals.

Qualifications

• Associates degree required.
• Three+ years in quality assurance, utilization management, case management, or health informatics.
• HMO or managed care experience preferred.
• Working knowledge of NCQA HEDIS technical specs and health plan processes preferred.

Responsibilities

• Assist Supervisor, Clinical Quality Improvement with HEDIS issues.
• Interpret clinical data for quality improvement studies and support medical management.

Skills

HEDIS knowledge

Education

Associates degree

Job description

IEHP seeks a Temporary HEDIS Improvement Nurse, RN in Rancho Cucamonga, CA. This agency-facilitated assignment lasts up to six months and supports IEHP’s clinical quality improvement initiatives.

Under supervision, the nurse interprets data for QI studies and maintains knowledge of MedHOK and related regulatory requirements from DHCS, DMHC, and CMS, contributing to IEHP’s quality goals.